Jiri Rehak, (Olomouc, Czech Republic), Evzen Fric, MD (Olomouc, Czech Republic), Matus Rehak, MD (Olomouc, Czech Republic), Barbora Babkova, MD (Olomouc, Czech Republic), Zuzana Pracharova, MD (Olomouc, Czech Republic)
It is generally thought that don’t exist effective treatment of central retinal vein occlusion (CRVO). This study evaluate the effect of anticoagulant treatment with warfarin on visual acuity (VA) in the therapy of CRVO and compare the results with no treated group.
We performed treatment of 60 eyes with CRVO using warfarin in prospective study. The patients were divided into two basic groups: ischemic (10) and nonischemic (50) CRVO. VA in nonischemic CRVO was also evaluated separately in group A – eyes with initial VA 6/60 and worse (15) and group B – eyes with initial VA 6/12 and better (19). Convertion of nonischemic to ischemic CRVO and incidence of neovascular glaucoma (NVG) was also evaluated. The results were statistically evaluated and compared with no treated CRVO (data published by Quinlan). Pretrombosis as an initial stadium of nonischemic CRVO is
defined as a newly introduced term.
As a failure is considered the incidence of final VA 6/60 and worse: nonischemic CRVO: 12 (24%), group A: 5 (33%), group B:1 (5%) – the result in nonischemic CRVO and in group A are significantly better than 50% and 88% in nontreated groups. The result in group B: 1(5%) is better than in nontreated group (21%) but is not statistically significant as well as number of conversions to ischemic CRVO: 3 (6%) in our group to 10% in nontreated group.The result in ischemic CRVO (100%) is almost the same as in nontreated group (93%). Incidence of NVG is very low – 2 (3%) if compared to published data: 20-30%.
Anticoagulant therapy with warfarin in the case of nonischemic CRVO brings significantly better visual result when compared with nontreated eyes. In the case of ischemic CRVO this therapy don-t influence the final VA but signifinatly reduces the occurance of NVG. This therapy also reduces occurance of conversion of nonichemic CRVO to ischemic one but without statistically significance.